AHA Calls for Creation of National Registry on Cardiorespiratory Fitness

Tuesday, January 15, 2013

AHA Calls for Creation of National Registry on Cardiorespiratory Fitness

A
new policy statement by the American
Heart Association (AHA) encourages clinicians to assess cardiorespiratory
fitness with the hope that researchers can gather more information on aerobic
fitness and its related variables to identify individuals who might be at risk
for adverse clinical outcomes.

The
AHA writing committee also advocates for the creation of a national registry
that includes data on cardiorespiratory fitness that would allow researchers to
track aerobic fitness over long periods of time, just as is being done with
other variables such as cholesterol, blood pressure, physical activity levels,
and body weight, among others. It also would provide more information on
normative aerobic fitness levels in subsets of the population.

According to a Heartwire article, one of the goals of the national
registry is to increase awareness about the importance of cardiorespiratory
fitness. Many of the assessments are performed in exercise centers and research
settings, but not as frequently in clinical practice.

While information is available in
pockets of the country, including data from the Aerobics Center Longitudinal Study, the hope is more information
would allow researchers to determine normative cardiorespiratory fitness
levels, via direct measurements of VO2, in groups stratified by age,
gender, and body composition in large samples representative of the US
population.

The registry also would help define
normative values of aerobic fitness across strata of physical activity levels.
Chair
of the AHA policy statement, Leonard
Kaminsky, PhD, told Heartwire that "physical activity is simply a behavior, and while
both are inversely associated with the risk of cardiovascular disease, there
are factors that contribute to aerobic fitness than other physical activity
levels, including age and genetics. In addition, cardiorespiratory fitness is a
more clinically meaningful measure than self-reported physical-activity levels,
which are prone to considerable error."

APTA member Ross
Arena, PT, PhD, is a coauthor of the statement, which was published online
ahead of print January
7 in Circulation.

A new APTA podcast that focuses on
screening for physical inactivity distinguishes between physical activity and
physical fitness, explains the use of physical activity to screen for issues of
impaired physical fitness, and provides information on what to do with the
results of the screen. It also gives examples illustrating various types of
patients and the role that physical activity plays in their overall
health.

Comments

This is important work. Studies done to assist with clinical decision-making regarding whether-or-not to administer a treatment in oncology, i.e. to surgically excise a metastatic tumor to the brain, find that a patient's performance status is the single biggest predictor of outcome. Since performance status is a reflection of a patient's cardiorespiratory fitness, I predict the data from this registry will enable clinicians to make more informed decisions regarding their treatments in areas beyond oncology.

Posted by Sarah Pedersen, PT
on 1/19/2013 10:50 AM

For more widespread application as we move forward with wellness I would think the modified Bruce protocol, aka the 12 min treadmill test would be a more readily available clinical tool. If APTA can work with AMA and CMS to create a code for billing wellness PTs will play a greater role in prevention of CAD and DM.